Pegylated liposomal doxorubicin (Caelyx™, Doxil®) represents an improved formulation of conventional
doxorubicin, with reduced
cardiotoxicity and an improved pharmacokinetic profile. This article reviews the efficacy and tolerability of
pegylated liposomal doxorubicin in metastatic
breast cancer, progressive
ovarian cancer, relapsed or refractory
multiple myeloma and
AIDS-related
Kaposi's sarcoma, as well as summarizing its pharmacological properties. In three randomized, open-label, multicentre trials, monotherapy with
pegylated liposomal doxorubicin was as effective as
doxorubicin or
capecitabine in the first-line treatment of metastatic
breast cancer, and as effective as
vinorelbine or combination
mitomycin plus
vinblastine in
taxane-refractory metastatic
breast cancer.
Pegylated liposomal doxorubicin alone was as effective as
topotecan or
gemcitabine alone in patients with progressive
ovarian cancer resistant or refractory to
platinum- or
paclitaxel-based
therapy, according to the results of three randomized multicentre trials. In addition, in patients with progressive
ovarian cancer who had received prior
platinum-based
therapy, progression-free survival was significantly longer with
pegylated liposomal doxorubicin plus
carboplatin than with
paclitaxel plus
carboplatin, according to the results of a randomized, open-label multicentre trial. Combination
therapy with
pegylated liposomal doxorubicin plus
bortezomib was more effective than
bortezomib alone in patients with relapsed or refractory
multiple myeloma, according to the results of a randomized, open-label, multinational trial. Randomized multinational trials also demonstrated the efficacy of
pegylated liposomal doxorubicin in patients with advanced
AIDS-related
Kaposi's sarcoma.
Pegylated liposomal doxorubicin exhibited a relatively favourable safety profile compared with conventional
doxorubicin and other available
chemotherapy agents. The most common treatment-related adverse events included myelosuppression, palmar-plantar erythrodysesthesia and
stomatitis, although these are manageable with appropriate supportive measures. To conclude,
pegylated liposomal doxorubicin is a useful option in the treatment of various
malignancies, including metastatic
breast cancer,
ovarian cancer,
multiple myeloma and
AIDS-related
Kaposi's sarcoma.